No difference in tibial lengthening index by use of Taylor Spatial Frame or Ilizarov external fixator

Abstract

Background Different methods and devices are used to perform lengthening and deformity reconstruction in the tibia. Recently, the Taylor spatial frame (TSF) has been introduced as a computer-assisted and versatile external ring fixator. Lengthening index (LI) and complications are important result parameters, and the aim of this study was to review our first 20 tibial segments operated with the TSF and to compare the results with our experience of using the traditional Ilizarov external fixator (IEF).Patients and methods We lengthened 20 tibial segments in 20 patients with the TSF. The results were compared with those of 27 tibial segments from 27 patients that were lengthened with the IEF. All segments were operated on with monofocal osteotomies.Results In the overlapping zone of comparable lengthening distances between 2.4 and 6.0 cm, the LI of 2.4 and 1.8 months/cm was not significantly different between the TSF and IEF groups, respectively (p = 0.17). This non-significant difference was confirmed after adjustment for age.Interpretation We found no difference between the TSF and IEF frames regarding LI and complication rate. However, rotational, translational, and residual deformity correction is easier to perform with the TSF.

Does the Taylor Spatial Frame Accurately Correct Tibial Deformities?

“…The TSF has been used for fracture treatment [4] and reconstruction of the tibia [8,10,11,14,23,24,28,40,44,45,47], ankle [22], femur [8,21,29], and upper extremity [38] in children and adults. Precise deformity correction and ease of use have been cited as advantages of the TSF [20,23,49].…”

Comparative clinical study on deformity correction accuracy of different external fixators

“…Lengthening indices and amounts were statistically similar for both groups. However, number of segments with reduced callus formation requiring bone grafting was higher in the spatial fixator group [20]. Additional evaluation of bone quality for lengthening cases with and without deformity, with a higher number of cases, is necessary to fully verify these results.…”

“…Various studies have been performed with spatial fixators, mostly case reports or case series [13][14][15][16][17][18][19]. Few comparative studies have been published [5,20]. In this study, Ilizarov CEF and spatial fixators were compared in similar patient groups.…”

Computer-aided surgical planner for a new bone deformity correction device using axis-angle representation

“…It has only two patient-adjusted joints (2DOF, a prismatic joint and a revolute joint), termed the "trajectory joints", but is capable of correcting a 3D deformity. According to past literature [8,10,12,[15][16][17][18][19][20][21][22][23][24], an effective fixator should correct up to 10 cm of length discrepancy. Very little is noted on the extent of angular deformity in literature.…”